1. U.S. EPA DISCLAIMER EPA strongly cautions that these study results should not be used to draw conclusions about local exposure concentrations or risk. The results are most meaningful when viewed at the regional or county level; for smaller areas, the study becomes less certain. In addition, these results represent conditions in 1999 rather than current conditions and only include exposures from outdoor sources of particulate matter. The results provide answers to questions about emissions, ambient air concentrations, exposures and risks across broad geographic areas for the year 1999. As such, they help the EPA identify specific air toxics compounds, and specific source sectors such as stationary sources or mobile sources, which generally produce the highest exposures and risks in the country. But they also are based on assumptions and methods that limit the range of questions that can be answered reliably. They cannot be used to identify exposures and risks for specific individuals, or even to identify exposures and risks in small geographic regions such as a specific neighborhood. These limitations, or caveats, must always be kept in mind when interpreting the results. The results should be used only to address questions for which the assessment methods are suited. All risk estimates are based on exposure estimates for the median individual within each census tract, which EPA considers to be a "typical" exposure. Some individuals may have substantially higher or lower exposures based on where they spend their time. The study is not designed to quantify these individual extremes.

2. The Diesel Difference Álvaro Alvarado, Ph.D. Environmental Protection Agency

3. BenMAP 1. Air Quality Modeling 2. Health Impacts – Epidemiology 3. Valuation

4. Air Quality Modeling 1999 National Air Toxics Assessment Non-road and On-road diesel PM Study Area: – Philadelphia – Delaware – Montgomery – Chester – Bucks

8. Air Pollution and Health Donora, PA – October 30-31, 1948 – 20 people dead – 7,000 Hospitalized – Half the population London Fog – December 5-9, 1952 – 12,000 people dead – Transportation disrupted – Prize winning cattle dead

9. Epidemiology American Cancer Society Study 1.2 Million participants 1982 - 1998 Controlled for: Age, gender, weight, smoking history, alcohol use, occupation, diet, education Each 10 µg/m 3 PM – 4% increase in all cause mortality – 6% increase in lung cancer – 8% increase in fatal heart attacks

11. Pre-Mature Deaths Pope A.C., et al. 2002. Lung cancer, cardiopulmonary mortality, and long ‑ term exposure to fine particulate air pollution. JAMA, vol. 287, no. 9, 1132-1141.

13. Asthma Attacks Bucks 330 Chester 190 Delaware 510 Montgomery 410 Philadelphia 2300 Vedal, S. et al. 1998. Acute effects of ambient inhalable particles in asthmatic and non- asthmatic children. Am. J of Respiratory and Critical Care Medicine. 157(4):1034-1043. Ostro, B. et al. 2001. Air pollution and exacerbation of asthma in African-American children in Los Angeles. Epidemiology. 12(2):200-208.

14. Non-Fatal Heart Attacks Ostro, B.D. 1987. Air pollution and morbidity revisited: A speciation test. J of Environ Economics Management. 14:87-98.

15. Work Loss Days Bucks 2,800 Chester 1,600 Delaware 4,000 Montgomery 3,700 Philadelphia 20,000 Ostro, B.D. 1987. Air pollution and morbidity revisited: A speciation test. J of Environ Economics Management. 14:87-98.

16. Work Loss Days Ostro, B.D. 1987. Air pollution and morbidity revisited: A speciation test. J of Environ Economics Management. 14:87-98.

19. Particulate Matter Worth Its’ Weight in Gold 260 Premature deaths 450 Non-fatal heart attacks 32,000 Missed days of work 3,700 Asthma attacks Valued at $1.4 billion Cost $37 million $4.4 million in lost wages Valued at $160,000

20. Particulate Matter Worth Its’ Weight in Gold Willingness to pay Cost of illness Lost wages

21. Willingness to Pay Standard regulatory approach Value of small reduction in risk Based on peer-reviewed studies: – Interviews – Market forces – Peoples willingness to accept risk for higher wages

22. Willingness to Pay Mortality Asthma Acute bronchitis $5.5 Million $42 to prevent “Bad asthma day” $360 to prevent 6 day episode

23. Cost of Illness Medical costs, lost wages Non-fatal Heart Attacks Hospital Admissions Asthma ER visits Age dependent $66k to $140K Depends on illness $12,378 to $18,387 $286

24. Lost Wages Data from 2000 Census Median Income by County – Bucks$39,286 – Chester$43,039 – Delaware$37,993 – Montgomery$41,894 – Philadelphia$31,338

25. How good are the results? Uncertainties – Modeling – Epidemiology – Valuation

26. To know that even one life has breathed easier because you lived – this is to have succeeded. Ralph Waldo Emerson